The present invention relates to a therapeutic apparatus having a patient responsive feedback means for monitoring and/or treating the behavior of a patient.
Various human activity involving abnormal or undesirable physical activities and phenomena is preferably instantly detected and disclosed for appropriate treatment. The field of speech and hearing is presently developing behavioral approaches for treating various speech and hearing defects and characteristics to produce controlled modification of verbal behavior. For example, stutterers are often treated using a masking technique in which the subject's voice is masked so he cannot hear himself speak. A portable device has been suggested in which a stutterer is provided with a small throat microphone that actuates a masking sound generator whenever and only while the subject is speaking. The masking sound generator is connected to a pair of ear pieces similar to those utilized in hearing aids which are placed in the subject's ears. The device produces masking therapy while the subject is speaking while allowing unimpeded hearing at other times. A portable auditory feedback device has also been suggested for treating of patients with dysphonia as a result of either vocal cord lesions or laryngeal hypertension. With this device, a small throat microphone is again attached to the patient's throat and an earphone is attached to the patient's ear. The microphone is connected to a sound generator to provide an auditory-feedback signal only in response to predetermined excessive loudness of the speaker's voice. The patient is continuously and instantaneously warned whenever there is an excessive vocal intensity thereby immediately indicating abusive loudness.
The device is fully described in the August, 1974 issue of The Journal of Speech and Hearing Disorders, and generally includes suitable sensitivity control for response adjustment in accordance with the particular patient as well as to insure that the tone generator is not activated in the presence of soft, normal breathing patterns. Screwdriver adjustable potentiometers are provided for controlling the sensitivity of the instrument and the feedback loudness of the tone generator. The voice intensity response instrument also included internal timer means providing measurement of total talking time and/or the total loud talking time for monitoring both functions simultaneously. Treatment with such a portable device is highly desirable in that treatment continues while the patients continue to function, including use of their voice. Alternate methods of treatment generally available are complete voice rest for periods up to six weeks or a surgical operation involving vocal cord stripping. Neither of these alternate methods change the habits of the patient and thus the physical ailment or defect may readily reoccur. It also, of course, does not permit continued normal patient functioning during the treatment. Such a device thus provides a significant method of behavioral approach to the modification of verbal behavior of the patient.
The present inventors have found that various response and detection characteristics of the system are highly significant in providing therapy or treatment. In treatment of various vocal disorders the detecting of abnormally low or soft speech may be required as well as excessive loud speech.